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Summary

Psychiatric pharmacists have specialized training and experience that allow them to effectively provide comprehensive medication management to patients with psychiatric and/or neurological disorders as part of a healthcare team. Comprehensive medication management (CMM) helps patients reach clinical goals of treatment, improve outcomes, and reduce overall healthcare costs.

The College of Psychiatric & Neurologic Pharmacists (CPNP) has developed an official position paper to help increase patient access to comprehensive medication management and to support efforts to obtain payment for the service. The CPNP Position Paper, entitled Improving Medication-Related Outcomes for Patients with Psychiatric and Neurological Disorders:  Value of Psychiatric Pharmacists as Part of the Healthcare Team” reviews the need for psychiatric pharmacists, the unique training and experience of the psychiatric pharmacist, outcomes from studies specifically examining interventions for patients with psychiatric and neurological disorders, and comprehensive medication management. The full version of this paper can be found in the January 2015 issue of the Mental Health Clinician.  A summary of the key points of this position paper can be found below.

CPNP Position Statement

  • All patients with psychiatric and neurologic disorders should have access to comprehensive medication management provided by a psychiatric pharmacist.
  • The demand for psychiatric services to treat psychiatric and neurological disorders has dramatically increased. Psychiatric pharmacists can help meet this demand by working with a physician as part of a collaborative team to improve medication-related outcomes for patients with psychiatric or neurological disorders.
  • Psychiatric pharmacists have specialized training or substantial experience in working with patients with psychiatric or neurological disorders. Board certification in Psychiatric Pharmacy from the Board of Pharmacy Specialties is the recommended method for recognizing that a pharmacist has the necessary knowledge and experience. 
  • Studies show that including a psychiatric pharmacist as a member of an interdisciplinary team is cost-effective and has a positive impact on clinical outcomes (e.g., effectiveness, adherence) by optimizing pharmacotherapy while decreasing the incidence of adverse effects associated with medication. This impact, in turn, increases patients’ engagement in treatment and improves their adherence to medication regimens.
  • Comprehensive medication management is a standard of care in which psychiatric pharmacists provide direct patient care by assessing all of a patient’s medications to determine that each medication is
    • Appropriate for the individual patient in terms of his or her diagnosis
    • Effective for the medical condition being treated
    • Safe, given patients’ comorbid conditions and other medications taken and with regard to each medication’s adverse effect profile
    • Able to be taken as intended and convenient for the patient. 
  • Comprehensive medication management is not a stand-alone service but is instead provided by the psychiatric pharmacist as part of the healthcare team, in collaboration with a physician. Studies have found that collaborative practice agreements between physicians and psychiatric pharmacists lead to positive outcomes and should be included as part of CMM.  Evidence supports CMM as a process of care that reduces costs and improves medication-related outcomes. Additional studies are needed to support the process of care to further optimize clinical outcomes and cost-effectiveness.
  • Mechanisms for paying for comprehensive medication management provided by psychiatric pharmacists must be identified if this service is to become a standard of care available to all patients with psychiatric or neurological disorders.
  • Psychiatric pharmacy is a recognized specialty and psychiatric pharmacists make valuable contributions to patient care. We recommend that psychiatric pharmacists, pharmacy educators, physicians, other non-pharmacy healthcare providers, and legislators take action to ensure that all patients with psychiatric or neurological disorders have access to comprehensive medication management provided by psychiatric pharmacists.

CPNP will continue to support legislation and actions that allow for the provision of comprehensive medication management services by Board Certified Psychiatric Pharmacists to all patients with psychiatric and/or neurological disorders All points of care, including patient centered medical homes are increasingly recognizing the need to integrate the treatment of psychiatric and neurologic disorders with other medical conditions to provide the best therapeutic outcomes for all coexisting conditions. Psychiatric pharmacists’ education and training make them uniquely qualified to participate in such integrated care as part of a multidisciplinary treatment team.

This paper, as a whole or in sections, can and should be used by the CPNP membership to support the CPNP position in discussions with patients, other healthcare providers including non-psychiatric pharmacists, pharmacy educators, lawmakers, and other policy makers.